Autism Spectrum Disorder (ASD) is a developmental and neurological disorder that affects how a person perceives, socializes, communicates and behaves. The term “spectrum” is used because patients can have a wide range of symptoms that begin in early childhood and may last through adulthood. There is no cure for ASD, but treatment can be effective in managing symptoms, including difficulty communicating with others and repetitive behaviors. Patients with ASD do not have physical characteristics that differentiate them from others, but typically have distant or awkward social behaviors that may make the interaction more difficult.
There is no single known cause for ASD, but most researchers believe that genetic mutations, possibly inherited, are the primary reason for children to develop ASD. Infants born extremely preterm (prior to 26 weeks gestation) and those with disorders such as fragile X syndrome and Rett syndrome are at increased risk of developing ASD. Children are screened at well visits with their primary provider beginning at 9 months and continue until 2-3 years old.
Patients will have an optimal ability to communicate needs and have optimal interpersonal relationships.
Autism Spectrum Disorder Nursing Care Plan
- Difficulty sleeping
- Rarely showing enjoyment of objects or activities
- Failure to make eye contact
- Overly focused interest in specific topics
- Increased or decreased sensitivity to light, noise, touch, and temperature
- Sing-song voice
- Detailed memory
Nursing Interventions and Rationales
- Perform nursing assessment progressively and slowly.
Begin slowly with visual inspection and progress through assessment as the child begins cooperating. Fast movements can cause anxiety and fear. Avoid anxiety as much as possible. Note any repetitive behaviors.
- Obtain information and history from the patient’s parents regarding triggers for anxiety and behaviors, eating habits, and sleeping patterns.
Determine baseline and expectations of how patients will react to the health care teams and procedures. Helps to determine the course of action and treatments and best practice for assessment of the patient.
- Have parents complete evaluation screening questionnaires such as ASQ or M-CHAT appropriate for age.
These are screening tools used at various ages and stages to determine in what areas the child may need assistance or therapy and severity of disability.
- Provide for safety. Place infants or toddlers in the crib, raise rails on the bed.
Many children with ASD also have seizure disorders. Provide for the safety of patients in case of seizure. Remove objects in the room that may cause injury in case of hyperactivity or anxiety.
- Sit down or position yourself near the patient’s eye level.
Patients may not make eye contact, but may often feel apprehensive about others standing over them. Being at eye level helps ease anxiety and build trust.
- Explain every procedure and demonstrate on self or parent
Patients may be more cooperative if procedures such as using a stethoscope are first done on yourself or the parent.
- Talk with the patient about their interests
Evaluate communication abilities and develop rapport and trust.
- Provide a calm and inviting atmosphere
- Avoid loud noises, radios, talking
- Turn off the TV during exam and evaluations
- Limit number of people in the room to those whom the patient is most comfortable with
Help the patient to feel more relaxed by avoiding excessive stimulation and distractions. Other children or siblings may need to be asked to leave if causing a distraction.
- Review diet and eating habits with parents and provide or recommend foods and food presentations that may make healthy choices more appealing.
Children with ASD often have aversions to food based on color, shape, or texture. Offering creative presentation ideas or ways of preparing foods may make them more interesting palatable for patients. Ensures more adequate nutritional balance.
- Administer medications appropriately as required
There are no medications to treat ASD, but some may be required to treat symptoms such as anorexia, inability to focus, depression, and seizures.
- Provide resource information and education for parents
- Help parents have less anxiety in caring for a child with ASD.
- Provide information on how to manage symptoms or behaviors.
- Help parents find therapists and counselors to help children with developmental disabilities.
- Teach alternative methods for coping with behaviors.
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell